Pilot Cluster Randomized Controlled Trials to Evaluate Adoption of Water, Sanitation, and Hygiene Interventions and Their Combination in Rural Western Kenya

Christensen, Garret; Dentz, Holly N.; Pickering, Amy J.; Bourdier, Tomoé; Arnold, Benjamin F.; Colford, John M.; Null, Clair

doi:10.4269/ajtmh.14-0138

Cited by 28 publications

(50 citation statements)

References 24 publications

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“…For each intervention arm, a series of BCC messages adapted for the local culture were developed. All intervention messages were tested and adapted to the local culture during the pilot phase of the study, details of which are provided elsewhere (Christensen et al, ). Training materials and visit scripts were developing during the pilot phases and are available at https://osf.io/fs23x.…”

Section: Methodsmentioning

confidence: 99%

A behaviour change intervention with lipid‐based nutrient supplements had little impact on young child feeding indicators in rural Kenya

Byrd

Dentz

Williams

et al. 2018

Maternal & Child Nutrition

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Poor infant and young child feeding (IYCF) practices are associated with linear growth faltering. Our objective was to evaluate the impact of a nutrition and water and sanitation for health intervention on three IYCF indicators-minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) in Kenyan children. Households were randomized into one of eight groups: (a) active control; (b) passive control; (c) water quality (W); (d) sanitation (S); (e) handwashing (H); (f) combined Water, Sanitation, and Handwashing; (g) nutrition (N); and (h) combined WSH + N. In the N and WSH + N arms, community-based promoters counselled households on optimal IYCF practices, and small-quantity lipid-based nutrient supplements (SQ-LNS) were provided to children 6-24 months of age. Twelve months (Year 1) and 24 months (Year 2) after interventions began, enumerators surveyed mothers to ascertain IYCF practices. We made pairwise comparisons of each intervention arm versus the active control arm using log binomial models. In total, 3,652 caretakers were surveyed at Year 1 and 4,987 caretakers at Year 2. Compared with the active control, there were no differences in any of the arms in MDD, MMF, or MAD, aside from an increase in MDD at Year 1 in the nutrition only arm but not in the combined WSH + N arm (N: 68%; WSH + N: 61%; C: 61%; N arm prevalence ratio: 1.13 95% CI [1.01, 1.25]). In this setting, a nutrition behaviour change communication intervention had little impact on IYCF indicators. The provision of SQ-LNS was not detrimental to current IYCF indicators in the community.

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Section: Methodsmentioning

confidence: 99%

A behaviour change intervention with lipid‐based nutrient supplements had little impact on young child feeding indicators in rural Kenya

Byrd

Dentz

Williams

et al. 2018

Maternal & Child Nutrition

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“…was in urban Dhaka, Bangladesh ; another study by Yeager et al . was conducted in a shanty town in urban Lima, Peru ; and all other studies were conducted in rural settings . Three were randomised controlled trials, and five were pre‐ and post‐evaluation studies.…”

Section: Resultsmentioning

confidence: 99%

“…Three were randomised controlled trials, and five were pre‐ and post‐evaluation studies. Hygiene education was a major component of all the interventions: four were studies of hygiene education alone ; two combined hygiene education with installation of water and sanitation infrastructure (hand pumps and/or latrines) ; one study provided hygiene education along with a faeces disposal sani‐scooper tool (a dust pan with a paddle), child potties and latrine improvements (including a plastic latrine slab with a drop‐hole cover) ; and one study implemented a potty training intervention . All eight studies included assessments of child faeces disposal practices.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of evidence on the effectiveness of safe child faeces disposal interventions

Morita

Godfrey

George

2016

Tropical Med Int Health

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Abstractobjectives To review and synthesise the available evidence on the effectiveness of interventions targeting unsafe child faeces disposal in reducing this behaviour and improving child health in lowand middle-income countries.methods PubMed and EMBASE were systematically searched. Studies meeting the inclusion criteria were reviewed and key information on study methodologies and outcomes were extracted.results A total of 1048 articles were screened, and eight studies representing five countries were included for the review. Three were randomised controlled trials, and five were prospective cohort studies. There was wide variability across studies in the definition of 'safe disposal' of child faeces. Six studies reported the change in child faeces disposal practices associated with safe child faeces disposal interventions. However, only one study found a significant improvement in this behaviour. Two of the six studies that evaluated the health impact of delivered interventions found significant reductions in childhood diarrhoea associated with safe faeces disposal practices, and one study reported a positive effect on child growth and ascariasis. Only one study was identified that delivered a single intervention solely focused on safe child faeces disposal. Unfortunately, this study did not investigate the impact of this intervention on child health.conclusions There are major methodological limitations in studies that assessed the impact of safe child faeces disposal interventions. The health impact of these interventions is inconclusive because the quality of the current evidence is poor. Randomised controlled trials are urgently needed to assess the impact of safe faeces disposal interventions on child health.

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“…20 In other Cochrane reviews, Cairncross et al proposed diarrhoea risk reductions of 17 and 36%, associated respectively, with improved water quality and excreta disposal. (21) 24 Previous sanitation campaigns like the Total Sanitation campaign and Nirmal Bharat Abhiyan were unable to significantly reduce the practice of open defecation. Hence SBM was launched in mission mode with a specific time frame.…”

Section: Discussionmentioning

confidence: 99%

Ecological study for prioritization of districts of Odisha for swacch bharat mission implementation based on a new modified environmental sanitation index using census 2011 and AHS 2012 data

Kshatri

Panda

Tripathy

2017

Int J Community Med Public Health

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Background: Open defecation practices and contaminated drinking water are the two major sources of excreta-related infections. Swacch Bharat Mission (SBM) is a cleanliness campaign launched in India in 2014 for duration of five years. Primary Objectives: 1. Determine the effect of open defecation and drinking water sources on the incidence of diarrheal diseases in Odisha. 2. Categorisation of the districts according to a Modified Environmental Sanitation Index (M.E.S.I).Methods: Type of study: Ecological study. Study instrument: Secondary data collected from Census of India-2011 and Annual Health Survey report, 2012. A Modified E.S.I (M.E.S.I.) score was calculated for Odisha using ESI template developed by Balamurugan and Ravichandran. Statistical analyses were done using GNU PSPP Statistical Analysis Software Release 0.9.0. Results: According to the Census of India, 2,129,276 (22.04%) households in Odisha used latrines, including water closet and pit latrines. From the AHS-2012 data it was found that the overall incidence of diarrhea /dysentery in Odisha was 5.92 per 1000 population. Association with diarrheal disease incidence was estimated after classifying districts into 4 categories according to the use of latrines as <10%, 10-20%, 20-30% and >30%. The mean incidence of diarrheal diseases was lower in districts that had higher use of toilets. The variables from each broad category were classified into positive and negative indicators for ESI calculation and MESI score was calculated. Based on the M.E.S.I, the districts were ranked. Dhenkanal, Kandhamal, Nayagarh were ranked worst. Conclusions: Districts should be prioritized based on MESI score for effective SBM implementation.

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Pilot Cluster Randomized Controlled Trials to Evaluate Adoption of Water, Sanitation, and Hygiene Interventions and Their Combination in Rural Western Kenya

Cited by 28 publications

References 24 publications

A behaviour change intervention with lipid‐based nutrient supplements had little impact on young child feeding indicators in rural Kenya

A behaviour change intervention with lipid‐based nutrient supplements had little impact on young child feeding indicators in rural Kenya

Systematic review of evidence on the effectiveness of safe child faeces disposal interventions

Ecological study for prioritization of districts of Odisha for swacch bharat mission implementation based on a new modified environmental sanitation index using census 2011 and AHS 2012 data

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